tbuckley/cabot-search huggingface dataset:
Screening for Clostridioides difficile colonization at admission to the hospital: a multi-centre study
Authors: Monique J.T. Crobach, Bastian V.H. Hornung, Cees Verduin, Margreet C. Vos, Joost Hopman, Nitin Kumar, Celine Harmanus, Ingrid Sanders, Elisabeth M. Terveer, Mark D. Stares, Trevor D. Lawley, Ed J. Kuijper
Journal: Clinical Microbiology and Infection (2023)

ObjectivesTo assess the value of screening for Clostridioides difficile colonization (CDC) at hospital admission in an endemic setting.MethodsA multi-centre study was conducted at four hospitals located across the Netherlands. Newly admitted patients were screened for CDC. The risk of development of Clostridioides difficile infection (CDI) during admission and 1-year follow-up was assessed in patients with and without colonization. C. difficile isolates from patients with colonization were compared with isolates from incident CDI cases using core genome multi-locus sequence typing to determine whether onwards transmission had occurred.ResultsCDC was present in 108 of 2211 admissions (4.9%), whereas colonization with a toxigenic strain (toxigenic Clostridoides difficile colonization [tCDC]) was present in 68 of 2211 admissions (3.1%). Among these 108 patients with colonization, diverse PCR ribotypes were found and no 'hypervirulent' PCR ribotype 027 (RT027) was detected (95% CI, 0–0.028). None of the patients with colonization developed CDI during admission (0/49; 95% CI, 0–0.073) or 1-year follow-up (0/38; 95% CI, 0–0.93). Core genome multi-locus sequence typing identified six clusters with genetically related isolates from patients with tCDC and CDI; however, in these clusters, only one possible transmission event from a patient with tCDC to a patient with CDI was identified based on epidemiological data.ConclusionIn this endemic setting with a low prevalence of 'hypervirulent' strains, screening for CDC at admission did not detect any patients with CDC who progressed to symptomatic CDI and detected only one possible transmission event from a patient with colonization to a patient with CDI. Thus, screening for CDC at admission is not useful in this setting.
DIFFERENCES IN MYOCARDIAL FLOW RESERVE AND PROGNOSIS BETWEEN PATIENTS WITH AND WITHOUT DIABETES
Authors: Pankaj Malhotra, Donghee Han, Ananya Singh, Robert JH Miller, Heidi Gransar, Sean W. Hayes, John D. Friedman, Louise Thomson, Alan Rozanski, Piotr Slomka, Daniel S. Berman
Journal: Journal of the American College of Cardiology (2023)
FACTORS ASSOCIATED WITH NON-COMPLIANCE OF MEDICINES IN PATIENTS HAD ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION AND NON-ST SEGMENT ELEVATION MYOCARDIAL INFARCTION: POST-DISCHARGE FOLLOW-UP STUDY
Authors: Zain Islam Arain, Muhammad Shahzeb Shaikh, Kartik Kumar Rathi, Muhammad Daniyal Javaid, Nimrata Kumari
Journal: Journal of the American College of Cardiology (2023)
THE EFFECT OF MEDICAL THERAPY ON TRICUSPID VALVE ANATOMY IN THE EVALUATION OF TRANSCATHETER TREATMENT OF TRICUSPID REGURGITATION
Authors: David Blusztein, Rebecca T. Hahn, Carlos Godoy Rivas, Stephen Tomlinson, Jay S. Leb, Isaac George, Susheel K. Kodali
Journal: Journal of the American College of Cardiology (2023)
RIGHT ATRIAL FUNCTION IN PATIENTS WITH SIGNIFICANT TRICUSPID REGURGITATION
Authors: Xavier Galloo, Federico Fortuni, Maria Chiara Meucci, Steele Butcher, Marlieke Dietz, Edgard Alexander Prihadi, Bernard Cosyns, Jeroen J. Bax, Nina Ajmone Marsan
Journal: Journal of the American College of Cardiology (2023)
'AIRED OUT’ RIGHT VENTRICLE: AN UNEXPECTED EMBOLUS DURING VA-ECMO SUPPORTED PERCUTANEOUS MECHANICAL THROMBECTOMY
Authors: Ali J. Noory, Sharana Hegde, Michael Nestasie, Muhammad Yasin, Adnan Khalif, Mithun Chakravarthy, David M. Lasorda
Journal: Journal of the American College of Cardiology (2023)
ACCURACY OF IVUS-BASED MACHINE LEARNING SEGMENTATION FOR THE ASSESSMENT OF CORONARY ARTERY VESSEL AND LUMEN DIMENSIONS AND BALLOON SIZING
Authors: Mitsuaki Matsumura, Gary S. Mintz, Tomotaka Dohi, Wenguang Li, Alexander Shang, Hajime Sakamoto, Hiroyuki Daida, Tohru Minamino, Akiko Maehara
Journal: Journal of the American College of Cardiology (2023)
FALSE-FALSE TENDON: DISSECTING INTRAMYOCARDIAL HEMATOMA DIAGNOSED BY CONTRAST ECHOCARDIOGRAPHY
Authors: Kahtan Fadah, Seyed Khalafi, Jan Lopes, EZHIL PANNEERSELVAM, Mehran Abolbashari, Kazue Okajima, Jorge Chiquie Borges
Journal: Journal of the American College of Cardiology (2023)
SOFA SCORE IS MODIFIED BY AIR POLLUTION EXPOSURE PRIOR TO CARDIAC ARREST - A CRITICAL CARE CARDIOLOGY TRIALS NETWORK (CCCTN) REGISTRY STUDY
Authors: Alok R. Amraotkar, Shahab Ghafghazi, Olivia Layne, Brittany Blair, Timothy O'Toole, Aruni Bhatnagar
Journal: Journal of the American College of Cardiology (2023)
ACUTE ALCOHOL EXPOSURE AND ELECTROCARDIOGRAPHIC CHANGES: FINDING FROM THE HOLIDAY (HOW ALCOHOL INDUCES ATRIAL TACHYARRHYTHMIAS) TRIAL
Authors: Luisa Ciuffo, Monica Tung, Jonathan W. Dukes, Eric Vittinghoff, Joshua D. Moss, Randall J. Lee, Byron K. Lee, Zian H. Tseng, Vasanth Vedantham, Jeffrey E. Olgin, Melvin M. Scheinman, Henry H. Hsia, Edward P. Gerstenfeld, Gregory M. Marcus
Journal: Journal of the American College of Cardiology (2023)
LIPOPROTEIN(A) LEVELS IN POPULATION WITH ESTABLISHED ATHEROSCLEROTIC CARDIOVASCULAR DISEASE IN THE UNITED STATES: A SUBANALYSIS FROM THE LP(A)HERITAGE STUDY
Authors: Michael D. Shapiro, Tariq Haddad, Howard S. Weintraub, Seth J. Baum, Khaled Abdul-Nour, Vadim Paluy, Wess Boatwright, Auris Browne, Imran Ayaz, Xiangyi Meng, Cheryl A. Abbas, Christie M. Ballantyne
Journal: Journal of the American College of Cardiology (2023)
C-PEPTIDE CORRELATES WITH ADVERSE EVENTS IN A DIVERSE, HIGH-RISK CORONARY ARTERY DISEASE COHORT
Authors: Shivang Desai, Omid Behbahani-Nejad, Frank Dicken, Jiwon Park, Nour Beydoun, Zahran Alras, Ayman Alkhoder, Zain Alvi, Romina Faridizad, Tanveer Kauser, Mohamed Afif Martini, Kiran Ejaz, Chang Liu, Yi-An Ko, Arshed A. Quyyumi
Journal: Journal of the American College of Cardiology (2023)
POOLED SAFETY ANALYSIS OF INCLISIRAN IN 3,576 PATIENTS WITH APPROXIMATELY 10,000 PERSON YEARS OF EXPOSURE FROM 7 TRIALS
Authors: R. Scott Wright, Wolfgang Koenig, Ulf Landmesser, Lawrence A. Leiter, Anastasia Lesogor, Pierre Maheux, Frederick J. Raal, Gregory G. Schwartz, Christian Stratz, Xiao Zang, Kausik Kumar Ray
Journal: Journal of the American College of Cardiology (2023)
INFORMATIONAL POSTCARDS IMPROVE ACCESS TO REMOTE MONITORING AMONG VETERANS WITH PACEMAKERS AND IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS: A STEPPED-WEDGE RANDOMIZED CONTROLLED TRIAL
Authors: Megan McLaughlin, Merritt H. Raitt, Gary Tarasovsky, Mary Whooley, Sanket Shishir Dhruva
Journal: Journal of the American College of Cardiology (2023)
Physical Examination
Authors: Stanley Wiener
Journal: JAMA (1976)

A method allowing for direct observation of intern and resident physicians while interviewing and examining patients has been in use on our medical wards for the last five years. A large number of errors in the performance of the medical examination by young physicians were noted and a classification of these errors into those of technique, omission, detection, interpretation, and recording was made. An approach to detection and correction of each of these kinds of errors is presented, as well as a discussion of possible reasons for the occurrence of these errors in physician performance. (<i>JAMA</i>236:852-855, 1976)
Vaginal Atrophy in the Postmenopausal Woman
Authors: Sandra Leiblum
Journal: JAMA (1983)

The effect of sexual activity on vaginal atrophy was investigated in a group of 52 postmenopausal women (mean age, 57 years). Subjects were divided into two groups: sexually active (intercourse frequency, three or more times monthly) and sexually inactive (intercourse frequency, less than ten times yearly). Two gynecologists examined all subjects and completed an index of vaginal atrophy that assessed six genital dimensions. Blood samples were also analyzed by radioimmunoassay for levels of circulating estrone, estradiol, androstenedione, testosterone, follicle-stimulating hormone, and luteinizing hormone (LH). As predicted, less vaginal atrophy was apparent in the sexually active women as opposed to the sexually inactive women. Further, women with less vaginal atrophy had significantly higher mean levels of androgens (androstenedione and testosterone) and gonadotropins (particularly LH). We discuss herein the implications of this study, particularly the importance of androgens in reducing atrophy and maintaining sexual interest. (<i>JAMA</i>1983;249:2195-2198)
Changes in Antipsychotic Drug Use in Nursing Homes During Implementation of the OBRA-87 Regulations
Authors: Ronald I, Shorr
Journal: JAMA (1994)

<h3>Objectives.</h3> —To describe the changes in antipsychotic drug use in nursing homes during the period surrounding the implementation of federal legislation designed to reduce unnecessary use (the Omnibus Budget Reconciliation Act of 1987 [OBRA-87]) and to identify nursing home characteristics associated with such changes. <h3>Design.</h3> —Longitudinal study of 9432 Tennessee Medicaid enrollees 65 years of age or older who continuously resided in Tennessee from April 1, 1989, to September 30,1991, a 30-month period surrounding implementation of OBRA-87. <h3>Main Outcome Measures.</h3> —Changes in the use of antipsychotic and other psychotropic drugs. <h3>Results.</h3> —During the 30-month period, antipsychotic drug use decreased from 23.9 to 17.5 days per 100 days of residence, a 26.7% decline (<i>P</i>&lt;.001), which resulted from both a decrease in new users (<i>P</i>&lt;.001) and a reduction in long-term use of antipsychotic drugs (<i>P</i>&lt;.001). There was no concomitant increase in other psychotropic drug use. A multivariate analysis revealed that changes in antipsychotic use were strongly associated with baseline antipsychotic use (<i>P</i>=.001) and third-shift staffing levels (<i>P</i>=.003). Nursing homes with baseline antipsychotic drug use and third-shift staffing above the median reduced antipsychotic drug use by 41%, compared with a 2% increase in nursing homes where both of these factors were below the median (<i>P</i>&lt;.0001). <h3>Conclusions.</h3> —A substantial decrease in antipsychotic drug use coincided with the implementation of OBRA-87. Although this decrease is consistent with an improvement in quality of nursing home care, further research is needed to determine the effects of this legislation on resident outcomes. (<i>JAMA</i>. 1994;271:358-362)
Countdown to Millennium—Balancing the Professionalism and Business of Medicine
Authors: George D. Lundberg
Journal: JAMA (1990)

In 1985, I published an editorial entitled "Medicine—A Profession in Trouble?"1 Unfortunately, in 1990 the question mark has come off. While we have made progress on some of the 11 reparative steps I recommended, we continue to get more deeply mired in questions of value for money. Outcome indicators do not demonstrate value consonant with the everincreasing percent of our gross national product that is consumed for medical and health care. And government intrudes more every day, micromanaging routine activities in the physician's life.<sup>2</sup> From antiquity, medicine has been and continues to be both a business and a profession.<sup>3,4</sup>Physicians are, by definition, both entrepreneurs and professionals. Cassel recently listed 10 features that distinguish a learned profession from others. They are self-governance individually and as a group; service to the poor without expectation of compensation; deliverance of quality; not ripping people off; high level of learning; autonomy of
Headache * Commentary: Headache in South America
Authors: T J Steiner
Journal: BMJ (2002)

# Headache {#article-title-2} A detailed systematic history is the key to diagnosing and effectively managing patients with this common and disabling condition Headache affects most people, at least occasionally. It is high among the reasons why people consult general practitioners and neurologists. 1 2 It may signal serious underlying illness, but, more importantly, it is associated with personal and social burdens of pain, disability, damaged quality of life, and financial cost. 3 4 It ought to be a huge public health issue, but headache receives little priority in the queue for healthcare resources.5 The diagnosis and management of most headaches require neither advanced neurological skills nor investigations. We reviewed published and other accessible information sources, including the World Health Organization's world health report,6 major epidemiological surveys, the classification and diagnostic criteria of the International Headache Society,7 reports of clinical trials, and selected national management guidelines. We used the definitive textbook on headache disorders— The headaches —as a reference source.8 Treatment recommendations in the present paper were based on evidence but, other than for the newer drugs, this was often limited to expert opinion and practice. Sufficient time committed to a systematic headache history is the key to effective diagnosis (see box 1). The correct diagnosis is not always evident initially, especially when the patient has more than one type of headache. A diary kept for a few weeks can establish the pattern of attacks, symptoms, and medication use. A change in pattern signals something newK—aggravating circumstances, or the onset of a new headache disorder. New headache, in young and old patients, needs especially careful inquiry. #### Summary box
Deep Venous Thrombosis and Pulmonary Embolism
Authors: Kenneth M. Moser
Journal: JAMA (1981)

Radiofibrinogen leg scans were performed in 34 patients admitted to a respiratory intensive care unit (ICU) for treatment of acute respiratory failure. In 23 patients, the leg scans were performed during the first ICU week, and abnormal leg scans developed in three (13%). In 11 patients, leg scans were done beyond the first week; all were normal. Autopsy incidence of embolism was 20%. No patient died of embolism. The low frequency of fatal embolism has led us to discontinue the routine use of low-dose heparin prophylaxis in these patients in our respiratory ICU. In its place, we have substituted an ongoing investigation of noninvasive monitoring with both radioactive fibrinogen leg scanning and impedance plethysmography. From such investigations should emerge more definitive strategies for dealing with venous thromboembolism in this complex patient population. (<i>JAMA</i>1981;246:1422-1424)
Metastatic Non-Oat-Cell Bronchogenic Carcinoma
Authors: Jacob D. Bitran
Journal: JAMA (1978)

Fifty-four patients with metastatic non-oat-cell bronchogenic carcinoma were treated with cyclophosphamide, doxorubicin hydrochloride (Adriamycin), methotrexate, and procarbazine hydrochloride (CAMP). Eighteen of 51 of these patients with measurable disease showed an objective response to CAMP chemotherapy, with a median survival of 12.6 months. Eight of the 18 patients are still alive, and two have been in continuous remission for 20 and 26 months. Survival for patients with stable disease was 12 months, similar to that for patients demonstrating objective regression in response to CAMP treatment. Weight loss, performance status, and dominant site of metastases proved to be important prognostic factors. The CAMP regimen was well tolerated; there were only two drug-related deaths, both secondary to infectious complications. (<i>JAMA</i>240:2743-2746, 1978)
Complete Genomic Screen in Late-Onset Familial Alzheimer Disease
Authors: Margaret A. Pericak-Vance
Journal: JAMA (1997)

<h3>Context.</h3> —Four genetic loci have been identified as contributing to Alzheimer disease (AD), including the amyloid precursor protein gene, the presenilin 1 gene, the presenilin 2 gene, and the apolipoprotein E gene, but do not account for all the genetic risk for AD. <h3>Objective.</h3> —To identify additional genetic risk factors for late-onset AD. <h3>Design.</h3> —A complete genomic screen was performed (N=280 markers). Critical values for chromosomal regional follow-up were a<i>P</i>value of.05 or less for affected relative pair analysis or sibpair analysis, a parametric lod score of 1.0 or greater, or both. Regional follow-up included analysis of additional markers and a second data set. <h3>Setting.</h3> —Clinic populations in the continental United States. <h3>Patients.</h3> —From a series of multiplex families affected with late-onset (≥60 years) AD ascertained during the last 14 years (National Insititute of Neurological Disorders and Stroke-Alzheimer's Disease and Related Disorders Association diagnostic criteria) and for which DNA has been obtained, a subset of 16 families (135 total family members, 52 of whom were patients with AD) was used for the genomic screen. A second subset of 38 families (216 total family members, 89 of whom were patients with AD) was used for the follow-up analysis. <h3>Main Outcome Measures.</h3> —Linkage analysis results generated using both genetic model-dependent (lod score) and model-independent methods. <h3>Results.</h3> —Fifteen chromosomal regions warranted initial follow-up. Follow-up analyses revealed 4 regions of continued interest on chromosomes 4,6,12, and 20, with the strongest results observed for chromosome 12. Peak 2-point affecteds-only lod scores (n=54) were 1.3,1.6, 2.7, and 2.2 and affected relative pairs<i>P</i>values (n=54) were.04,.03,.14, and.04 for<i>D12S373, D12S1057, D12S1042</i>, and D12S390, respectively. Sibpair analysis (n=54) resulted in maximum lod scores (MLSs) of 1.5,2.6,3.2, and 2.3 for these markers, with a peak multipoint MLS of 3.5. Apriori stratification by<i>APOE</i>genotype identified 27 families that had at least 1 member with AD whose genotype did not contain an<i>APOE*4</i>allele. Analysis of these 27 families resulted in MLSs of 1.0,2.4,3.7, and 3.3 and a peak multipoint MLS of 3.9. <h3>Conclusions.</h3> —A complete genomic screen in families affected with late-onset AD identified 4 regions of interest after follow-up. Chromosome 12 gave the strongest and most consistent results with a peak multipoint MLS of 3.5, suggesting that this region contains a new susceptibility gene for AD. Additional analyses are necessary to identify the chromosome 12 susceptibility gene for AD and to follow up the regions of interest on chromosomes 4, 6, and 20.
How to Report Randomized Controlled Trials
Authors: Drummond Rennie
Journal: JAMA (1996)

The best evidence on the efficacy of medical interventions comes from well-conducted, randomized controlled trials (RCTs), but unless such trials are reported adequately, it is impossible to assess that information. In response to increasing evidence that reporting of RCTs is imperfect, there has been a concerted effort to set standards for reporting RCTs, the process described by Begg et al<sup>1</sup>in this issue ofTHE Journal. See also p 637. In December 1994,<i>JAMA</i>published the Standards of Reporting Trials (SORT) statement.<sup>2</sup>We followed this with the publication of a trial using all the SORT headings.<sup>3</sup>In an accompanying Editorial,<sup>4</sup>I called for the SORT group to agree on common standards with another group that had met in Asilomar.<sup>5</sup>Representatives of both groups were brought together by David Moher, MSc, of the University of Ottawa. Their discussions were informed by comments from readers, many of
Adverse Reactions to Drugs and Chemicals
Authors: Nelson S. Irey
Journal: JAMA (1974)

A registry for studying the morphological changes that occur in patients with adverse reactions to drugs was established more than eight years ago. Since then, 2,700 cases have been accessioned. There are major problems in analyzing and diagnosing alleged drug-reaction cases. Consultative, investigative, and educational functions of the registry have been developed. Recognizing the need for correlating the morphological with the clinical and clinical-laboratory findings, the registry has carried out 18 investigations on selected cases. (<i>JAMA</i>230:596-598, 1974)
A Clinical and Immunological Study of Allergy to Hen's Egg White
Authors: Tor Langeland
Journal: Allergy (1982)

A CIE‐reference precipitation pattern for hen's egg white was established, using rabbit anti‐egg antiserum. It demonstrated 24 different immunoprecipitates. The precipitates corresponding to ovalbumin, ovomucoid and lysozyme were identified in the reference pattern.
Leukocytosis in Acute Appendicitis
Authors: Paul Hyman
Journal: JAMA (1974)

To determine if the relative neutropenia previously reported in healthy American, West Indian, and African blacks might also occur in patients with inflammatory disease, preoperative white blood cell (WBC) counts were compared among 112 cases of histologically proven acute appendicitis. Statistically significant lower WBC and neutrophil counts were found in black patients than in an identical group of whites. (<i>JAMA</i>229:1630-1631, 1974)
Association of Supplemental Nutrition Assistance Program Retailers With Child Food Insecurity During the COVID-19 Pandemic
Authors: Qingxiao Li, Shuoli Zhao, Metin Çakır, Zhixiu Yu
Journal: JAMA Pediatrics (2023)

This cross-sectional study of US Department of Agriculture and census data examines differences in child food insecurity and changes in Supplemental Nutrition Assistance Program (SNAP) retailers before and after the start of the COVID-19 pandemic.
Vincristine and dexamethasone pulses in addition to maintenance therapy among pediatric acute lymphoblastic leukemia (<scp>GD‐ALL</scp>‐2008): An open‐label, multicentre, randomized, phase <scp>III</scp> clinical trial
Authors: Kun‐yin Qiu, Jia‐yi Wang, Li‐bin Huang, Chang‐gang Li, Lu‐hong Xu, Ri‐yang Liu, Hui‐qin Chen, Yong‐sheng Ruan, Zi‐jun Zhen, Chi‐kong Li, Jian‐pei Fang
Journal: American Journal of Hematology (2023)

The efficacy and safety on the addition of vincristine (VCR) and dexamethasone (DEX) pulses to maintenance therapy among childhood acute lymphoblastic leukemia (ALL) remain uncertain. Herein, we perform an open-label, multicentre, randomized, phase III clinical trial that was conducted at nine major medical centers in Guangdong Province, China. Patients were randomly assigned either the conventional maintenance therapy (control group, n = 384) or the VCR/DEX pulse (treatment group, n = 375). When limited to the SR cohort, 10-year EFS was 82.6% (95% CI: 75.9-89.9) in the control group and 80.7% (95% CI: 74-88.1) in the treatment group (pnon-inferiority = .0002). Similarly, patients with IR also demonstrated non-inferiority of the treatment group to the control group in terms of 10-year EFS (73.6% [95% CI: 67.6-80] vs. 77.6% [95% CI: 71.8-83.9]; pnon-inferiority = .005). Among the HR cohort, compared with the control group, patients in the treatment group experienced a significant benefit in terms of 10-year EFS (61.1% [95% CI: 47.7-78.2] vs. 72.6% [95% CI: 55.6-94.7], p = .026) and a trend toward higher 10-year OS (73.8% [95% CI: 61.6-88.4] vs. 87.9% [95% CI: 579.2-97.5], p = .068). In the HR cohort, the total rate of drug-induced liver injury and Grade 3 chemotherapy-induced anemia were both lower for patients in the treatment group than in the control group (55.6% vs. 100%, p = .033; 37.5% vs. 60%, p = .036). Conversely, the total prevalence of chemotherapy-induced thrombocytopenia was higher for patients in the treatment group than in the control group (88.9% vs. 40%, p = .027). Pediatric acute lymphoblastic leukemia with high risk is suitable to VCR/DEX pulse during maintenance phase for the excellent outcome, while the standard-to-intermediate-risk patients could eliminate the pulses.